JOHN MICHAEL GREEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

NOT RENEWED

Business

First Name

JOHN MICHAEL

Last Name

GREEN

Business Name

JOHN MICHAEL GREEN

Original Issue Date

02/24/1992

Effective Date

02/24/1992

Expiration Date

09/30/1994

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005